60-day FR

Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices
Dated: March 8, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–4901 Filed 3–22–07; 8:45 am]
BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10095]

Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS), Department of Health
and Human Services, is publishing the
following summary of proposed
collections for public comment.
Interested persons are invited to send
comments regarding this burden
estimate or any other aspect of this
collection of information, including any
of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the Agency’s function;
(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Detailed
Explanation of Non-Coverage and
Notice of Medicare Non-Coverage and
Supporting Regulations in 42 CFR
422.624 and 42 CFR 422.626; Use:
Providers will deliver a Notice of
Medicare Non-Coverage to enrollees at
least two days prior to the end of
covered services in skilled nursing
facilities, home health agencies, and
comprehensive outpatient rehabilitation
facilities. Enrollees will use this
information to determine whether they
wish to appeal the service termination
to the Quality Improvement
Organization (QIO) in their State. If the
enrollee decides to appeal, the Medicare
Health organization will send the QIO
and the enrollee a Detailed Explanation
of Non-Coverage detailing the rationale

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for the termination decision. Form
Number: CMS–10095 (OMB#: 0938–
0910); Frequency: Reporting: Yearly;
Affected Public: Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 454; Total
Annual Responses: 47,558; Total
Annual Hours: 23,780.52.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS Web site
address at http://www.cms.hhs.gov/
PaperworkReductionActof1995, or email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
[email protected], or call the
Reports Clearance Office on (410) 786–
1326.
Written comments and
recommendations for the proposed
information collections must be mailed
or faxed within 30 days of this notice
directly to the OMB desk officer: OMB
Human Resources and Housing Branch,
Attention: Carolyn Lovett, New
Executive Office Building, Room 10235,
Washington, DC 20503, Fax Number:
(202) 395–6974.
Dated: March 16, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–5296 Filed 3–22–07; 8:45 am]
BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10216, CMS–R–
0053, CMS–179, CMS–10137, CMS–10069
and CMS–R–246]

Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS) is publishing the
following summary of proposed
collections for public comment.
Interested persons are invited to send
comments regarding this burden
estimate or any other aspect of this
collection of information, including any
of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions;

AGENCY:

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(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Alternative
Benefits State Plan Amendment Health
Opportunity Accounts (HOA)
Demonstration Program; Use: The DRA
provides States with numerous
flexibilities in operating their State
Medicaid programs. For example,
Section 6082 of the DRA allows up to
10 States to operate Medicaid
demonstrations to test alternative
systems for delivering their Medicaid
benefits. Under these demonstrations,
States would have the flexibility to
deliver their Medicaid benefits to
volunteer beneficiaries through a
program that is comprised of an HOA
and a High Deductible Health Plan
(HDHP). Under the DRA, States can
submit a State Plan Pre-print to CMS to
effectuate this change to their Medicaid
programs. CMS will provide a State
Medicaid Director letter providing
guidance on this provision and the
implementation of the DRA and the
associated State Plan Amendment
template for use by States to modify
their Medicaid State Plans if they
choose to implement this flexibility;
Form Number: CMS–10216 (OMB#:
0938–1007); Frequency: Reporting: Onetime; Affected Public: State, Local or
tribal Government; Number of
Respondents: 56; Total Annual
Responses: 10; Total Annual Hours: 10.
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Imposition of
Cost Sharing Charges Under Medicare
and Supporting Regulations Contained
in 42 CFR 447.53; Use: The purpose of
this collection is to ensure that States
impose nominal cost sharing charges
upon categorically and medically needy
individuals as allowed by law and
implementing regulations. States must
identify in their State plan the
following: (1) The service for which the
charge is made; (2) The amount of the
charge; (3) The basis for determining the
charge; (4) The method used to collect
the charge; (5) The basis for determining
whether an individual is unable to pay
the charge and the way in which the
individual will be identified to
providers; and, (6) The procedures for
implementing and enforcing the
exclusions from cost sharing; Form

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Federal Register / Vol. 72, No. 56 / Friday, March 23, 2007 / Notices

Number: CMS–R–0053 (OMB#: 0938–
0429); Frequency: Reporting:
Occasionally; Affected Public: State,
Local or tribal Government; Number of
Respondents: 56; Total Annual
Responses: 2; Total Annual Hours: 20.
3. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Transmittal and
Notice of Approval of State Plan
Material and Supporting Regulations in
42 CFR 430.10–430.20 and 440.167;
Use: The CMS–179 is used by State
agencies to transmit State plan material
to the Centers for Medicare & Medicaid
Services (CMS) for approval prior to
amending their State plan. The State
plan is the method in which States
inform staff of State policies, standards,
procedures and instructions. The CMS–
179 is currently used by State agencies
administering the Medicaid program
and CMS regional offices (RO). State
agencies use the form to submit State
plan amendments (SPAs) (including
supporting documentation) to the CMS
RO for review and approval prior to
amending their plan in accordance with
42 CFR 430.10–430.20. The CMS–179
includes instructions for completing the
form. The inclusion of instructions is to
assist State agencies in completing the
form, thereby ensuring a more uniform
and timely plan amendment approval
process. The CMS–179 is the only
source available to State agencies for
submittal/approval of SPAs. This plan
amendment approval process is
necessary to ensure the State plan
continues to meet statutory and
regulatory requirements and thereby
ensure the State’s eligibility for Federal
financial participation. CMS will use
this information to track the estimated
Federal budget impact associated with
the SPAs. This information may result
in more accurate Federal Medicaid
expenditure estimates; Form Number:
CMS–179 (OMB#: 0938–0193);
Frequency: Reporting: Occasionally;
Affected Public: State, Local or tribal
Government; Number of Respondents:
56; Total Annual Responses: 10; Total
Annual Hours: 560.
4. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Application for
Prescription Drug Plans (PDP);
Application for Medicare Advantage
Prescription Drug (MA–PD);
Application for Cost Plans To Offer
Qualified Prescription Drug Coverage;
Application for Employer Group Waiver
Plans To Offer Prescription Drug
Coverage; Service Area Expansion
Application for Prescription Drug
Coverage; Use: Collection of this

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information is mandated in Part D of the
Medicare Prescription Drug,
Improvement, and Modernization Act of
2003. The application requirements are
codified in Subpart K of 42 CFR part
423. Coverage for the prescription drug
benefit is provided through prescription
drug plans (PDPs) that offer drug-only
coverage, or through Medicare
Advantage (MA) organizations that offer
integrated prescription drug and health
care coverage (MA–PD plans). PDPs
must offer a basic drug benefit.
Medicare Advantage Coordinated Care
Plans (MA–CCPs) must offer either a
basic benefit or may offer broader
coverage for no additional cost.
Medicare Advantage Private Fee for
Service Plans (MA–PFFS) may choose to
offer a Part D benefit. Cost Plans that are
regulated under Section 1876 of the
Social Security Act, and Employer
Group Plans may also provide a Part D
benefit. If any of the contracting
organizations meet basic requirements,
they may also offer supplemental
benefits through enhanced alternative
coverage for an additional premium.
The information will be collected
under the solicitation of proposals from
PDP, MA–PD, Cost Plan, and Employer
Group Waiver Plans applicants. The
collected information will be used by
CMS to: (1) Insure that applicants meet
CMS requirements, and (2) support the
determination of contract awards.
The major program change that has
occurred in Part D applications was that
CMS removed several attestations
related to Health Insurance Portability
and Accountability Act (HIPAA), bids
and privacy; Form Number: CMS–10137
(OMB#: 0938–0936); Frequency:
Reporting: Once; Affected Public:
Business or other for-profit and Not-forprofit institutions; Number of
Respondents: 857; Total Annual
Responses: 857; Total Annual Hours:
28,122.
5. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Medicare
Waiver Demonstration Application; Use:
The Medicare Waiver Demonstration
Application will be used to collect
standard information needed to
implement congressionally mandated
and administration high priority
demonstrations. The application will be
used to gather information about the
characteristics of the applicant’s
organization, benefits, and services they
propose to offer, success in operating
the model, and evidence that the model
is likely to be successful in the Medicare
program. The standard application will
be used for all waiver demonstrations
and will reduce the burden on

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applicants, provide for consistent and
timely information collections across
demonstrations, and provide a userfriendly format for respondents; Form
Number: CMS–10069 (OMB#: 0938–
0880); Frequency: Reporting: Once;
Affected Public: Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 75; Total
Annual Responses: 75; Total Annual
Hours: 6000.
6. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Medicare
CAHPS Survey; Use: The collection of
Consumer Assessment of Healthcare
Providers and Systems (CAHPS) Survey
measures is necessary to hold health
and prescription drug plans accountable
for the quality of care and services they
deliver. This requirement will allow
CMS to obtain information for the
proper oversight of the program. This
information is used to help beneficiaries
choose among plans, contribute to
improved quality of care through
identification of quality improvement
opportunities, and assist CMS in
carrying out its responsibilities; Form
Number: CMS–R–246 (OMB#: 0938–
0732); Frequency: Reporting: Yearly;
Affected Public: Individuals or
households; Number of Respondents:
660,000; Total Annual Responses:
660,000; Total Annual Hours: 217,800.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’ Web Site
address at http://www.cms.hhs.gov/
PaperworkReductionActof1995, or email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
[email protected], or call the
Reports Clearance Office on (410) 786–
1326.
To be assured consideration,
comments and recommendations for the
proposed information collections must
be received at the address below, no
later than 5 p.m. on May 22, 2007.
CMS, Office of Strategic Operations
and Regulatory Affairs, Division of
Regulations Development—A,
Attention: Melissa Musotto, Room C4–
26–05, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850.
Dated: March 16, 2007.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. E7–5297 Filed 3–22–07; 8:45 am]
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